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Bioprocess 2025
耐碳青霉烯肺炎克雷伯菌临床特征与危险因素
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Abstract:
目的：通过分析住院患者耐碳青霉烯肺炎克雷伯菌(Carbapenem-resistant Klebsiella pneumoniae, CRKP)的临床特征与危险因素，旨在为CRKP的诊断和治疗给予理论支撑。方法：采用回顾性研究方法选取安徽医科大学第一附属医院2023年6月至2024年7月住院患者分离出的肺炎克雷伯菌(Klebsiella pneumoniae, KP)。按菌株对碳青霉烯类药物的敏感性划分成两个组别：碳青霉烯敏感肺炎克雷伯菌(Carbapenem-susceptible Klebsiella pneumoniae, CSKP)组(n = 106)与CRKP组(n = 74)。收集所有研究对象的临床数据，并采用单因素分析和多因素logistic回归分析来分析住院患者发生CRKP的危险因素，明确各因素之间的关联以及对感染风险的影响程度，为后续的预防和控制感染提供科学依据。结果：180例KP患者中检出CRKP 74例，其中男性43例，女性31例。CRKP菌株主要来自重症医学科，其次为感染科和康复科，标本主要来源于痰液、血液和尿液。单因素分析显示，住院天数 ≥ 10天、肺部疾病、泌尿道感染、入住ICU史、入住ICU ≥ 5天、抗生素使用 > 14天、联用抗生素、呼吸机、尿道插管、中心静脉置管、气管镜检、胃管置入均与CRKP感染有关(p < 0.05)。多因素分析结果显示，泌尿道感染、抗生素使用 > 14天、中心静脉置管为CPKP感染的独立危险因素。结论：泌尿道感染、抗生素使用 > 14天、中心静脉置管是导致CRKP菌株感染形成的独立危险因素，在临床防治CRKP感染中应加以重视。
Objective: To analyze the clinical characteristics and risk factors of Carbapenem-resistant Klebsiella pneumoniae (CRKP) in hospitalized patients, aiming to give theoretical support for the diagnosis and treatment of CRKP. Methods: Klebsiella pneumoniae (KP) isolated from patients hospitalized in the First Affiliated Hospital of Anhui Medical University from June 2023 to July 2024 were selected using a retrospective study. The strains were divided into two groups according to their susceptibility to carbapenems: the carbapenem-susceptible Klebsiella pneumoniae (CSKP) group (n = 106) versus the CRKP group (n = 74). Clinical data of all study subjects were collected. Univariate analysis and logistic regression analysis were used to analyze the risk factors for the occurrence of CRKP in hospitalized patients, to clarify the association between the characteristics and the degree of influence on the risk of infection, and to provide a scientific basis for the subsequent prevention and control of infection. Results: CRKP was detected in 74 of 180 KP patients, including 43 males and 31 females. CRKP strains were mainly from the Department of Intensive Care Medicine, followed by the Department of Infectious Diseases and the Department of Rehabilitation, and specimens were mainly from sputum, blood, and urine. Univariate analysis showed that hospitalization days ≥ 10 days, pulmonary disease, urinary tract infection, history of ICU stay, ICU stay ≥ 5 days, antibiotic use > 14 days, combined antibiotics, ventilator, urethral intubation, central venous catheterization, tracheoscopy, and gastric tube placement were all associated with
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